12000814 Serrano, JumerQuestion 4 1. FallIt is defined as an individuals move toward to place on the floor or other lower level; occasionally a body part hits against an object that stops them from falling. People do not fall because they become older and falls do not just happen without any reason. Frequently, there are risk factors or primary cause involved in it. Some incident of falls is related to individuals medical problem or health condition, such as chronic diseases. Other reasons may be due to safety hazards in the facility or community environment.(Merck Manual, 2015)The Kindly Residential Care Rest Home focuses on reducing or preventing the incident of possible falls and other injuries that related to fall and its complications while keeping the patients independence and function as much as possible.EffectsMany people especially elderly adult have had an incident of fall that resulting in an injury. However, some of the elderly encounter severe injury from falls causes them hospitalisation and sometimes death. Even if there is no injury happened physically, a fall can cause loss of confidence and independence, unwillingness to perform task and be afraid of falls to happen again.

Management1. Kindly Residential Care Rest home will evaluate patient after the incident of fall to address and recognize risk factors and to deal with the primary health conditions.2. Staff training about risk factors of fall and preventive measures in Kindly Residential Care Rest home.3. Making modifications in the Kindly Residential Care Rest home environment to provide residents move safely and comfortably. Such modification include placing handrails in the hallways, putting down the height of the bed, installing grab bars and adding elevated toilet seats.4. Supplying Kindly Residential Care Rest home patients with hip pads to avoid hip fracture if a fall happens.5. Kindly Residential Care Rest home will implement programs that can enhance walking ability, strength and balance among residents.6. Studying the effects of prescribed medicines to evaluate their possible benefits and risks to all the patients of Kindly Residential Care Rest home.2. Skin tearsThese are wounds caused by friction or direct force and shear causing the skin layers to separate, first defined by Payne and Martin in 1993. Skin tears are painful injury which can result in partial thickness (separation of the epidermis from the dermis) or full thickness (separation of the epidermis and dermis together from underlying structures).(Wounds international, 2011)Elderly are prone for suffering skin tears, along with those people with a previous history of skin tears, lack of independence or bed ridden, limitation in mobility, bruised skin, swelling of the skin, fluid volume deficit and compromised nutrition that is why quality care should be provided to all.EffectsMost of the elderly are affected by this injury but it can be prevented. Friction, direct force, shearing is the reason resulting to separation of the skin layers. These skin damages are not serious enough but are unappealing injuries, painful for the patient.Management1. Kindly Residential Care rest Home will implement an organized protocol to prevent skin tear2. Kindly Residential Care rest Home will make sure that those patient at risk wear long trousers, long sleeves or high knee socks3. Kindly Residential Care rest Home will ensure safe environment and techniques in handling patient.4. Kindly Residential Care rest Home will make sure that the patients and their families are involve in prevention strategies5. Kindly Residential Care rest Home will educate caregivers, nursing staff and all healthcare worker to guarantee proper handling of patients without causing skin tears in providing care6. Kindly Residential Care rest Home consult a dietician to make sure that the hydration and nutrition of all the patients are adequate7. All staffs of Kindly Residential Care rest Home will make sure that they apply hypoallergenic moisturizer to patients skin at least twice a day to keep it well lubricated.ReferencesCentres for Disease Control and prevention. (2014). Falls in nursing homes. Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.htmlMerck Manual. (2015). Falls in the elderly. Retrieved from http://www.merckmanuals.com/professional/geriatrics/falls_in_the_elderly/falls_in_the_elderly.html Wounds International. (2011). Skin tears made easy. Retrieved from http://www.woundsinternational.com/pdf/content_10142.pdf